Provider Demographics
NPI:1356662712
Name:BRYANT, ANTOINETTE
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 WATERS EDGE DR
Mailing Address - Street 2:APT. A
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8840
Mailing Address - Country:US
Mailing Address - Phone:615-351-0633
Mailing Address - Fax:
Practice Address - Street 1:201 UFFELMAN DR
Practice Address - Street 2:SUITES E & F
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2975
Practice Address - Country:US
Practice Address - Phone:931-920-7330
Practice Address - Fax:931-920-7332
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker